Pakistan is such a country,
where religious, traditional and culture values are given more preference than
any body’s life. Majority of people concern about their traditions and may
scarify any body’s life to save their traditions and values. Due to illiteracy /
unawareness, many Pakistanis consider illegal sexual relationship, the only
cause of the disease because HIV/AIDS is a disease which directly links with
religious and cultural values. This attitude often generates fear,
misunderstanding and discrimination amongst general public and patients.
Misunderstandings are created by inaccurate or insufficient knowledge related to
HIV/AIDS. Discrimination and isolation can be exacerbated by emotional,
cultural, sexual and religious influences. Due to non availability of proper
medicines and undiscovered vaccine, the person infected starts counting his/her
days towards death. Victims being already under severe depression due to fear of
death, when observe the attitude of people, they suffer in psychosocial
problems.
Ever since the beginning of AIDS epidemic in Pakistan, the number of people
infected and affected by HIV/AIDS is on rise. During the course of infection,
many physical, social, psychological needs and problems have been experienced.
Nature of illness imposes a variety of psychological and emotional strains on
individuals and those closest to them. Taking into account the dilemma
associated with it, the affect of HIV epidemic are enormous. It is seen more as
a psychosocial phenomenon than a disease. The term “Psychosocial” means the
relationship factor and the social context in which they occur, recognizing that
mental health is closely linked to culture,religion,tradition,and relationship ,
Due to religious, cultural and social environment in Pakistan the epidemic is
taken as a crime, therefore, sense of fear, stigma and discrimination accompany
the disease. Patient is rejected by his family / friends and society because the
epidemic is associated with the stigma of illegal sexual activities which is a
sin/crime in Islam.
In Pakistan, people living with HIV/AIDS (PLWHAs) are often seen as shameful as
they are believed to bring shame upon the family and community. By blaming them,
society can very easily excuse itself from the responsibilities of caring and
looking after such individuals. PLWHAs are not only faced detestation and
discrimination but also denied all access to services/ facilities they deserve.
Society takes them as criminals without investigating the cause of the disease
which can be through legal sexual activities with their spouse or through
infected blood/ needles etc. HIV/AIDS mainly affects young adults, often heads
of families, at the peak of their economic activities, with tremendous effects
on life-expectancy, equality, poverty, and social dependency e.g. surviving
orphans. The disease undermines recent achievements in developing and may be the
most important macro-economic and social determinant of human welfare and
poverty in some countries
In Pakistan, HIV/AIDS patients suffered with many psychosocial problems due to
following reasons
• Unawareness among general public about the cause and mode of spread.
• Religious and moral belief leads people to believe that HIV/AIDS is the result
of moral fault and victim is deserved to be punished.
• Patients are being thought of responsible for becoming affected
• HIV/AIDS is life threatening disease without treatment which ultimately leads
to death
• Wrong perception that it can be transfer by touch, hugs cough, talk or eating
together.
Illegal sexual intercourse being the major cause of HIV/AIDS and due to non
availability of treatment / vaccination, victim has to face many Psychosocial
Problems which destroy him/her physically and mentally. Due to religious,
cultural and social environment in Pakistan the disease is taken as a crime,
therefore, sense of fear, stigma and discrimination accompany the disease.
Patient is rejected by his family / friends being a responsible of bringing
shame for them. If on one side HIV+ persons becomes physically sick due to the
affects of disease consequently on other side he/she has to face social boycott
which makes him mentally sick too. Healthy community does not think that victim
can be infected by blood transfusion or by her/him spouse but they just start
blaming the patient.
Causes of the Disease
HIV does not belong to the virus family which is found in air or dirt/grime and
passed by person to person through air like influenza etc. The Virus is found
only in the body of HIV+ Person. Unless and until the contaminated blood or
Virus is not entered into the blood of a healthy body, one can not be infected.
Therefore, the cause of disease is only Transfer of virus from infected person
to the blood of healthy one. A person who is HIV-infected carries the virus in
certain body fluids, including blood, semen, vaginal secretions, and breast
milk. The virus can be transmitted only if such HIV-infected fluids enter the
bloodstream of another person. This kind of direct entry can occur (1) through
the linings of the vagina, rectum, mouth, and the opening at the tip of the
penis; (2) through intravenous injection with a syringe; or (3) through a break
in the skin, such as a cut or sore.
Symptoms
• Abdominal cramps
• Nausea
• Vomiting
• Diarrhea
• Enlarged lymph nodes in the neck
• Armpits and groin
• Fever. Headache. Muscle aches and joint pain
• Skin rash
• Sore throat
• Weight loss
• Dry cough, Fatigue, Fever, Loss of appetite, Mouth sores Nail changes
• Night sweats, swollen lymph nodes in the neck, armpits, and groin
• Pain when swallowing, Personality changes
• Repeated outbreaks of herpes simplex
• Shortness of breath, Tingling, numbness, and weakness in the limbs
• Unexplained weight loss, Yeast infection of the mouth (thrush),pneumonia
• Cancer
It can Transfer by following ways
• Sexual intercourse with HIV+ person
• Transfusion of blood or blood product obtained from an infected donor
• Injecting or skin piercing equipment contaminated with HIV
• Mother to infant during pregnancy
• Breast feeding by HIV+ mother
• Transplantation of infected organ
HIV can not be transferred by following means
• Coughing or sneezing
• Handshakes
• Insect bites
• Work or school contact
• Touching or hugging
• Using toilets
• Water or food
• Using telephone
• Kissing where French kiss with injury of lips is not involved
• Swimming together
• Public bath
• Sharing cups, glasses, plates and other eating and drinking utensils
Prevention:- When we know that HIV can be transfered in three main ways. e.g
• Sexual transmission
• Transmission through blood
• Mother-to-child transmission
Than we can take preventive measures against these three with following methods:
1. Sexual transmission
Preventions
• Abstain from any illigal sex
• Be faithful to one partner
• Condomise, which means using male or female condoms consistently and correctly
2. Transmission through blood
Preventions
• Screening all blood supplies for the virus
• Reducing the number of unnecessary transfusions
• Routinely sterilising equipment in use
3. Mother-to-child transmission
Preventions
• HIV can be transmitted from a mother to her baby during pregnancy, labour and
delivery, and later through breastfeeding.The first step towards reducing the
number of babies infected in this way is to prevent HIV infection in women, and
to prevent unwanted pregnancies.
• Antiretroviral drugs given to her during pregnancy and labour as well as to
her newborn baby can greatly reduce the chances of the child becoming infected
• A caesarean section is an operation to deliver a baby through its mother’s
abdominal wall, which reduces the baby’s exposure to its mother’s body fluids.
This procedure lowers the risk of HIV transmission
• Refrain from breastfeeding
Recommendation
After carrying out the research on Psychosocial Problems of HIV/AIDS Patients, I
have following Recommendations
For the solution of Psychological Problems.
1. General public should be educated to show sympathetic behaviour towards
patients of HIV/AIDS
2. Patients be Counseled by qualified Psychologists
3. To keep the privacy intact,Government should open a free Telephonic helpline
for patients and general public for giving them information about HIV/AIDS
4. Maximun seminars/public meeting be arranged for giving education to general
people about HIV/AIDS
5. Individual, community, institution and nation must act with responsibiltiy
towards patients to prevent its spread and to care for those infected and
otherwise affected
6. HIV/AIDS Information Help Desk Service be kept at major market areas
7. As a recreational facility, sport events for victims be arranged
8. A human rights component should be included in all services delivery projects
to reduce stigma & discrimination and ensure that they are conducted in
accordance with ethical principles
9. Families / friends of HIV+ persons be counselled properly for dealing with
the patients
To slove the Social Problems
10. Government should solve their economical problems through Zakat Head in Bail
ul Mal
11. GO/NGO should provide Free Medications to patients
12. Invitation be given by GO/NGO to all HIV+ persons on special
occasions/gathering e.g on EIDs,14 Aug ,23 Mar ect
13. Laws against discriminations of HIV/AIDS Patients be made and enforced
14. HIV tested medical report during Nikkha be produced by both partner
15. Strict laws to use condom be made and enforced for MSWs,Injection Drug User
and FSWs
16. Orphan children of HIV/AIDS affected families should be supported by Bail ul
Mal
17. Relegios leaders should include 5 mintues speech about this disease during
Juma khutba and motivate the people to behave normally with HIV/AIDS patients
18. All people should have the ability to protect themselves from infection by
being able to refuse unsafe sex and cope with HIV/AIDS if they or someone in
their family is infected
General Recommendations
19. Health Insurance should be neccassary for working of Vulnerable Group e.g
FSW and persons working in labourteries
20. All hospitals be instructed to not use unsterilised syrings /other medical
equipments
21. Basic Information and preventive measures about HIV/AIDS be attached with
Boarding card of persons going abroad
22. To educate the people of rural areas, movies about HIV/AIDS be shown on
Mobile Cinema
23. In evry city,town and village there are councils which work under
Nazims.Every council should have a three member HIV/AIDS Fight
Commiitee,consists of a doctor a r religious leader and a social worker, whose
tasks should be to spread information about HIV/AIDS, take care of HIV+ persons
and keep eye on vulnerable group
24. Community based VCT services be provided in area inhabited by high risk
groups
25. VCT services should be expended to the general population.Communication
campaign for general population be included promotion of VCT and care services
26. Govt should make a law to emborse a permanent stamp on the arm all HIV+
People, as HIV+ . This will reduce to risk to spread HIV by Blood or Sex